- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $18,279.80 / $29,854.10
| Facility | | $6,303.00 | $18,279.80 | $29,854.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,143.45 / $33,205.54 / $44,554.66
| Facility | | $24,143.45 | $33,205.54 | $44,554.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,781.34 / $27,165.03 / $38,080.91
| Facility | | $19,781.34 | $27,165.03 | $38,080.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,221.43 / $30,169.81 / $38,034.26
| Facility | | $17,221.43 | $30,169.81 | $38,034.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,808.05 / $28,334.65 / $38,794.87
| Facility | | $17,808.05 | $28,334.65 | $38,794.87 |